| NPI | 1245529767 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN R1552) | 
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX R1552) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-05 | 
| Last Update Date | 2025-03-11 |